Ayurvedic Treatment for Tinnitus in Kerala

Ayurvedic Concept of Tinnitus

Tinnitus is a clinical condition in which patients usually present with ringing sounds or sometimes distorted hearing and a sense of fullness in the ear.

Tinnitus symptoms resemble Karnanada, and a variety of Karnarogas (diseases affecting the ear) have similar etiology.

When the Vata dosha is aggravated in the channels of the ear, different sounds are frequently experienced.

This condition is called Karnanada. When Karnanada is not treated correctly, it leads to deafness.

Karnanada (Tinnitus) is described under 80 types of Vata Vyadhi. Srotra (ears) is the seat of Vata dosha. Indriyabhramsa (derailment of sensory organs) is one of the symptoms of Vata vriddhi. Since the dosha predominance in this disease is Vata, the Vatahara treatment methodology indicated was found to be effective in the management of Karnanada (Tinnitus)

The treatment protocol for Karnanada (Tinnitus) includes Ghritapana (therapeutic intake of medicated ghee) and Karnapooranam (oil instillation in the ears). Samana Sneha with Guggulutiktaka Ghritam can be administered to alleviate the condition. The other necessary treatment procedure, Karnapooranam, carried out with Ksharatailam, is specially indicated for Tinnitus and deafness.

Abhyanga (massage therapy) is one of the necessary treatment modalities for Vata-oriented diseases.

Pichu (medicated oil application), one of the Murdhataila therapies, is said to be therapeutically better than Abhyanga and was performed here. Murdhataila is considered one of the best treatment modalities to pacify Vata in the head region.

How to diagnose Tinnitus

If you experience Tinnitus, first contact your primary care physician, who will look for earwax or fluid from an ear infection that may be clogging your ear canal.

Your doctor will also ask about your medical history to determine whether an underlying ailment or medication causes your Tinnitus.

Then, you may be sent to an ENT. The ENT will ask you to explain the tinnitus noises and when they began, and they will examine your head, neck, and ears.

You may also be sent to an audiologist, who may test your hearing and assess your Tinnitus.

Tinnitus is diagnosed through a combination of clinical examination and diagnostic investigations. Your ENT may prescribe imaging studies, particularly if your Tinnitus pulsates. Imaging examinations such as magnetic resonance imaging (MRI), computed tomography (CT), or ultrasound can be used in tinnitus diagnosis.

The following procedures are commonly used to assess and confirm the condition:

Medical History

History plays a vital role in the diagnosis of Tinnitus. Your physician may ask you specific questions for easy diagnosis.

When did it start?

Was it gradual or sudden onset? Gradually, it might suggest aging or exposure to noise, while sudden onset may be linked to trauma or loud sounds.

Is it in one or both ears?:

Tinnitus in one ear could be due to earwax buildup and blockage or an infection.

Is it constant or occasional?:

Constant noise might be related to hearing loss, while episodes could indicate Meniere’s disease.

Associated symptoms, if any?:

Symptoms like giddiness or hearing loss provide additional clues regarding diagnosing Meniere’s disease.

Physical Examination

A doctor will look for visible signs and changes in the ears and surrounding areas.

Ear inspection:

Checking for earwax buildup, infection, or damage to the eardrum.

Listening for sounds:

A stethoscope is used to detect vascular (blood flow) issues around the neck or ear.

Physical Tests

Otoscopy

○       Examination of the ear using an otoscope.

1. Nystagmus

○       Observed only if there are associated acute attacks of vertigo.

1. Tuning Fork Tests

○       These tests help differentiate between conductive and sensorineural hearing loss:

■       Rinne Test: Positive, indicating sensorineural hearing loss in the affected ear.

■       Absolute Bone Conduction: Reduced in the affected ear.

■       Weber Test: Lateralised to the better ear in cases of sensorineural hearing loss.

1. Investigations
2. Pure Tone Audiometry

○       Reveals sensorineural hearing loss.

○       In the early stages, lower frequencies are affected, showing a rising curve.

○       As the disease progresses, higher frequencies become involved, resulting in a flat or falling curve.

1. Speech Audiometry

○       Demonstrates discrimination scores between 55–85% during symptom-free periods.

○       Discrimination ability is significantly impaired during and immediately after an attack.

1. Special Audiometry Tests

○       Used to confirm the cochlear nature of the disease and differentiate it from retro cochlear lesions (e.g., acoustic neuroma):

■       Recruitment Test: Positive for Meniere’s disease.

■       SISI Test (Short Increment Sensitivity Index): Typically better than 70% in one-third of patients.

■       Tone Decay Test: Shows a decay of less than 20–40 dB, consistent with cochlear involvement.

1. Electrocochleography (ECoG)

○       Diagnostically significant in Meniere’s disease.

○       The standard ratio of summating potential (SP) to action potential (AP) is less than 30%.

○       In Meniere’s disease, the SP/AP ratio exceeds 30%, a key diagnostic indicator.

1. Imaging and Blood Tests

If the cause isn’t clear, further tests may help:

• MRI or CT scans: Used if the Tinnitus is in one ear or has a pulsating nature, suggesting a possible blood vessel or nerve issue.
• Blood tests: To rule out issues like thyroid problems, anemia, or high cholesterol.

1. Advanced Tests (If Needed)

In some cases, additional measurements are done:

• Pitch and loudness matching: Comparing the tinnitus sound to external noises.
• Masking tests: Finding sounds that may temporarily reduce Tinnitus.

When to See a Specialist

If Tinnitus is in one ear, pulsating, or affects daily life significantly, referral to an ear specialist (ENT doctor) is often recommended for advanced evaluation and treatment options.

Which are the parts affected?

Tinnitus primarily affects the auditory system, but its impact can extend to related regions:

Ears:

The inner ear, especially the cochlea and auditory nerve, is directly affected

Auditory Pathways:

Nerves and brain regions responsible for processing sound may show hyperactivity or abnormal signals

Temporal Lobe:

This part of the brain processes auditory information and may be involved in tinnitus perception

Jaw and Neck:

Muscle or joint dysfunction in these areas can exacerbate tinnitus symptoms

Cardiovascular System:

In cases of pulsatile Tinnitus, blood vessels near the ear may play a role.

Risk Factors

Age:

Advancing age increases the risk of Tinnitus and hearing loss

Loud Noise Exposure:

Prolonged exposure to loud noises increases the risk of Tinnitus

Lifestyle:

Smoking, excessive caffeine, and alcohol consumption can add risk

Stress:

Chronic stress and anxiety may worsen tinnitus symptoms

Occupational Hazards:

Jobs involving loud machinery or music increase susceptibility

Medical Conditions:

Hypertension, diabetes, and thyroid disorders can increase the risk of developing Tinnitus

Medications:

Ototoxic drugs, such as certain antibiotics and aspirin, may cause Tinnitus.

Genetics: A family history of hearing disorders can predispose individuals to Tinnitus.

Ayurvedic Treatment for Tinnitus

Ayurvedic treatments focus on balancing the doshas to address the root cause of Tinnitus. Common therapies include:

Ghritapana:

Therapeutic intake of ghee for balancing vata aggravation can be beneficial for tinnitus. Medicated ghee formulated to target the head and neck region is used in treatment.

Karna Purana:

It involves pouring warm, medicated oil into the ears to lubricate and nourish ear structures. This specialized therapy is considered extremely beneficial in managing and preventing the recurrence of Tinnitus.

Nasya:

Nasya– Installation of medicated liquids through the nasal passage to clear toxins and improve auditory health

Karna Pradesha Abhyanga and Sudation:

Massaging and Perspiring the area around the ears, as well as full-body massage using herbal oils, can help manage and prevent the recurrence of Tinnitus

Karna Pichu:

Applying thick cotton soaked in medicated oil/ ghee inside the ear gives oleation to the ear region, thereby balancing vata dosha and managing Tinnitus.

Shirodhara:

Shirodhara – a Continuous pouring of herbal oils over the forehead region to balance the aggravated Vata dosha can aid in managing Tinnitus

Virechana:

A detoxifying purgative therapy that cleanses the digestive system by administering laxative formulations that eventually help balance aggravated Pitta and  Vata dosha.

Ayurvedic Herbs and Formulations Used for Tinnitus

Herbs

• Ashwagandha: Reduces stress and strengthens nerve health
• Brahmi: Improves cognitive function and reduces Vata imbalance
• Haritaki: Aids in detoxification and enhances auditory health
• Bilva: Nourishes the auditory system and supports inner ear function
• Dashamoola: A combination of ten herbs that balance Vata and reduce inflammation
• Triphala: Promotes detoxification and balances all three doshas.

Formulations

• Karna Bindu Taila
• Ksheerabala  Taila
• Apamarga Kshara Taila
• Sarivadi vati
• Pathyakshadhatryadi kashaya

Diet and Lifestyle Recommendations

Adopting a tinnitus-friendly diet and lifestyle can significantly complement Ayurvedic treatments:

Diet Recommendations:

Include Nourishing Foods:

Add warm, easily digestible meals such as soups, stews, and cooked vegetables to your diet.

Add Essential Ingredients:

Incorporate barley, wheat, rice, green gram, and ghee for a balanced and wholesome diet.

Stay Hydrated:

Drink plenty of warm water and herbal teas to support overall hydration.

Habits and Practices to Avoid:

Avoid Harsh Practices:

Refrain from brushing with harsh tools, taking head baths in ponds/rivers, and excessive exertion.

Say No to Picking Ears:

Avoid inserting objects into your ears to prevent irritation or damage.

Limit Exposure to Cold:

Avoid wandering in cold weather or engaging in activities that worsen the body’s vata dosha.

Avoid Aggravating Foods:

Avoid vata-aggravating foods like spicy, oily, and processed items.

Reduce Noise Exposure:

Limit exposure to loud sounds, especially earbuds; use wired earphones and ear protection when necessary.

Limit Phone Usage:

Phone use may be a risk factor for developing Tinnitus as it emits non-ionizing electromagnetic radiofrequency radiation (EMRFR). A study found that people who used their phone for an average of 10 minutes daily had a 70% increased risk of Tinnitus.

Lifestyle Tips for Overall Well-Being:

• Practice Yoga and Meditation: Engage in relaxation techniques to manage stress and anxiety effectively.
• Maintain Regular Sleep: Follow a consistent sleep schedule to rejuvenate the body and mind.

Preventive methods

• Pratimarsha nasya with Anutailam can be advocated as a part of the daily routine.
• Before bathing, Massage the ear area, especially the back portion of the ear, with medicated oils or plain sesame oil.
• Instill 1-2 drops of pure sesame oil in the ears at any time of the day; however, avoid this if you have bleeding/ infection in your ears.
• Apply oil before bath on the bregma (midportion of the head) daily.
• Cover your head and ears before stepping out of cold weather, as cold air can aggravate Vata dosha in the body.
• Avoid picking your ears frequently with earbuds or fingers; instead, use a cloth to clean the external area
• Use wired headphones instead of wireless Bluetooth earbuds; if using, keep the volume to the minimum and limit the usage timing.

Home remedies for Tinnitus 

• Instill a few drops of lukewarm mustard oil/ sesame oil in your ears.
• Massage the area around the ears with warm sesame or mustard oil.
• Follow this with a steam therapy.
• Herbal teas made with Ginger, Ashwagandha/ fenugreek can provide some relief.
• Wear earplugs or noise-canceling headphones.
• Practice Yoga asanas like Trikonasana (triangle pose), Adho Mukha Svanasana (downward-facing dog), Gomukhasana (cow face pose), Bhujangasana (cobra pose), Matsyasana (fish pose), Balasana (Child’s pose) and Meditation.